Document Detail


Post-partum cerebral angiopathy: repetitive TCD, MRI, MRA, and EEG examinations.
MedLine Citation:
PMID:  12238622     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report of a woman with post-partum cerebral angiopathy (PCA), in whom we repetitively performed transcranial Doppler sonography (TCD), MR imaging (MRI), and MR angiography (MRA) to evaluate the underlying pathophysiology. A 31-year-old woman, Gemini pregnant, complained of severe throbbing frontal headache four days after an uneventful delivery by Cesarean section. Blurred vision occurred eight days after delivery, followed by three generalized tonic-clonic seizures. Neurological examination revealed a somnolent woman without focal neurological deficits. At the day of the seizures increased flow velocities and disturbed flow were observed in the right posterior and anterior cerebral artery on transcranial Doppler (TCD). MRI showed infra- and supratentorial patchy hyperintensities in T2-weighted images and in the FLAIR sequence. Diffusion-weighted imaging revealed corresponding multi-focal hyperintense areas indicating increased diffusion and MRA showed a diffuse multisegmental narrowing of all pial arteries. MRI at day 10 was completely normal, but MRA still revealed vascular narrowing in the right posterior cerebral artery. General slight flow accelerations in all basal arteries occurred after 10 days and lasted for three weeks. PCA is apparently associated with a vascular narrowing causing cerebral ischemia with increased diffusion. Later reactive cerebral hyperperfusion is observed. Vascular narrowing and cerebral hyperperfusion still persist after MRI has normalized.
Authors:
Peter Zunker; Kirstin Golombeck; Joachim Brossmann; Dimitrios Georgiadis; Günther Deuschl
Publication Detail:
Type:  Case Reports; Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  24     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-19     Completed Date:  2003-01-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  570-2     Citation Subset:  IM    
Affiliation:
Department of Neurology, Kiel University Hospital, Germany. peter.zunker@wegmanklinik.ch
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MeSH Terms
Descriptor/Qualifier:
Acetic Acids / therapeutic use
Adult
Amines*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Anticonvulsants / therapeutic use
Aspirin / therapeutic use
Brain Edema / diagnosis,  drug therapy,  pathology*
Cerebral Angiography
Cerebral Arteries / pathology*,  physiopathology
Cerebral Hemorrhage / diagnosis,  drug therapy,  pathology*
Cerebrovascular Circulation
Cyclohexanecarboxylic Acids*
Echoencephalography*
Eclampsia / diagnosis,  etiology
Female
Humans
Magnetic Resonance Angiography*
Magnetic Resonance Imaging*
Observer Variation
Oxytocin / therapeutic use
Postpartum Period
Pregnancy
Sensitivity and Specificity
Time Factors
Ultrasonography, Doppler, Transcranial*
gamma-Aminobutyric Acid*
Chemical
Reg. No./Substance:
0/Acetic Acids; 0/Amines; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anticonvulsants; 0/Cyclohexanecarboxylic Acids; 50-56-6/Oxytocin; 50-78-2/Aspirin; 56-12-2/gamma-Aminobutyric Acid; 60142-96-3/gabapentin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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